Nose reshaping (rhinoplasty)

Nose reshaping (rhinoplasty)

Nose reshaping (rhinoplasty, or a ‘nose job’) is an operation to change the shape or size of the nose.It’s not usually available on the NHS if done for cosmetic reasons, but may be provided on the NHS if it’s needed to help you breathe.Nose reshaping surgery is a delicate, complex operation. The results can’t be guaranteed, there are risks to consider, and it can be expensive. Be sure about your reasons for having it before you go ahead.It’s a good idea to discuss your plans with your GP first. You can also read “Is cosmetic surgery right for me?”

How much does it cost?

The cost of nose reshaping in the UK ranges from £4,500 to £7,000. You should also factor in the cost of any consultations, further surgery or follow-up care that may be needed.

Where do I go?

If you’re looking in England, check the Care Quality Commission (CQC)website for treatment centres that can perform a rhinoplasty. All independent clinics and hospitals that provide cosmetic surgery in England must be registered with the CQC, which publishes inspection reports and performance ratings to help people choose care.

You should also research the surgeon who is going to carry out the rhinoplasty. All doctors must, as a minimum, be registered with the General Medical Council (GMC). Check the register to see the doctor’s fitness to practise history. You may also want to find out:

how many operations they’ve performed where there have been complications

what sort of follow-up you should expect if things go wrong

their own patient satisfaction rates

What does it involve?

Nose reshaping is usually carried out under general anaesthetic.

The surgeon may do any of the following:

make the nose smaller (nose reduction), by removing some of the cartilage and bone

make the nose larger (nose augmentation), by taking cartilage from the ears and bone from the hips, elbow or skull, and using this to build up the nose (known as a “graft”)

change the nose’s shape (including the nostrils), by breaking the nose bone and rearranging the cartilage

change the angle between the nose and top lip

The skin over the nose should just shrink or expand to its new shape.

The operation involves either making one cut across the skin between the nostrils (“open rhinoplasty”), or tiny cuts inside the nostrils (“closed rhinoplasty”).

A closed rhinoplasty leaves no visible scars and causes less swelling, but isn’t always possible or available.

Either way, the procedure can take from an hour and a half to three hours. Most people would need to stay in hospital for one or two nights.

You’d probably leave hospital with dressings (“packs”) in each nostril, and a splint held over your nose with tape. You wouldn’t be able to breathe through your nose.

Painkillers would be given to control any mild pain.

Recovery

You may need to take up to two weeks off work to recover.

It might be several months before you see the full effect of the nose operation, and up to six months for all of the swelling to completely go.

You wouldn’t be able to drive for a few days after the operation – your surgeon would advise about this.

After about a week: Stitches would be removed (unless you had dissolvable stitches). The splint may be able to come off.

At three weeks: Bruises, swelling and redness may have faded. You may be able to swim.

At four to six weeks: You may be able to resume contact sports.

You’d probably be advised to:

prop your head up with pillows for a couple of days when resting, to reduce the swelling

avoid hot baths and getting the splint wet

avoid blowing your nose or removing any crusts until your appointment to have the splint removed

sneeze through your mouth, to avoid pressure on your nose

avoid dusty or smoky places

avoid strenuous exercise or contact sports for four to six weeks

take paracetamol or another prescribed painkiller to relieve any mild pain

Side effects to expect

It’s common after nose reshaping to have:

a blocked nose – you’d need to breathe through your mouth for a week or so

stiffness and numbness of the nose

soreness, swelling and bruising around the eyes, which can last three weeks

light nosebleeds for the first few days

What could go wrong

Nose reshaping surgery can occasionally result in:

permanent breathing difficulty

damage to the cartilage wall between your nostrils

an altered sense of smell

heavy nosebleeds

Any type of operation also carries a small risk of:

excessive bleeding

developing a blood clot in a vein

infection

an allergic reaction to the anaesthetic

The surgeon should explain how likely these risks and complications are, and how they would be treated if they occurred.

What to do if you have problems

Cosmetic surgery can sometimes go wrong and the results may not be what you expected.

You should contact the clinic where the operation was carried out as soon as possible if you have severe pain or any unexpected symptoms.

If you have a rhinoplasty and are not happy with the results, or you think the procedure wasn’t carried out properly, you should take up the matter with your surgeon through the hospital or clinic where you were treated.